Multilingual therapists in Madrid: Sinews supports children, adults and families

SINEWS is a multilingual therapy clinic in Madrid that provides high-quality mental health support to the international community, both in person and online. 

With a diverse team of licensed professionals, they offer a wide range of services, including psychological counselling, psychiatry, speech therapy, and specialised support for children, families, and couples.

We spoke with Dr Orlanda Varela MD PhD to learn more about their approach and her advice on finding the right therapy for your needs.

Could you tell us a little about Sinews? What inspired the clinic’s creation and what makes your approach to therapy unique?

Sinews started in 2008. One of the founders, Vickie Andrews (currently Saint Louis University counsellor), was an American expat who became very aware of the struggle of not speaking Spanish well enough to get mental health support. We aimed to deliver quality mental services to the international community in Madrid in their mother tongue. We understood how important it was for our patients to be able to express their feelings and worries in their own language, and to connect with a therapist that either had the experience of being an expat, was a third culture kid themself or had had a studying abroad experience. 

Our approach is unique because our team makes it so. It is their culturally rich profiles, experiences and backgrounds that allow us to provide such a complete service to all of our patients. We are a multidisciplinary workplace and teamwork is our strength. Our professionals work in coordination with skilfulness, quality and warmth while always respecting confidentiality.

Sinews offers a wide range of therapies. Can you give us an overview of the different types of therapy available?

• Child and adolescent psychological therapy (including Play Therapy for the youngest, and parenting sessions) in more than 6 languages. 
• Child and adolescent psychiatry (in English, French, German and Spanish).
• Couples and family therapy (in English, French and Dutch).
• Speech therapy by native English-speaking professionals treating both language disorders like stuttering (stammering) or difficulties articulating certain sounds and learning disorders (reading and/or writing like dyslexia) as well as swallowing problems and malpositioning of the tongue leading to orthodontic problems.
• Psychological testing for ADD, autism, high capacities and dyslexia, among others.
• English speaking Mums and Babies group.
• Family consultation on multilingualism and a workshop on raising bilingual kids.

You work with a diverse, multilingual team. Can you tell us more about their specialisations, qualifications, and the languages they speak?

All of the professionals who work at Sinews have the required licenses and titles according to Spanish law to work as health professionals in Spain, even if they are foreign, so that their activity is fully legal and is covered by our civil responsibility insurance.

Besides those main requirements, which are a Bachelor’s Degree and specialisation Masters, each professional has a different background and training. This enables us to cover a range of specialised areas: couples counselling, family therapy and individual therapy for eating disorders, substance addiction, grief, anxiety, depression, autism and more. 

We also offer a variety of therapeutic approaches and methods. Cognitive Behavioural Therapy is the basis we all master, and many of our professionals have extra training in EMDR and trauma therapy, Schema therapy, Gottman Method, PACT, dialectic-behavioural, systemic therapy, or ACT (Acceptance and Commitment Therapy).

Regarding languages, we joke about our kitchen being as multicultural as NATO. Our international team offers services in English, German, French, Italian, Arabic, Chinese, Polish, Dutch, Danish, Slovak, Romanian, Hebrew  and, of course, Spanish.

How important is it for clients to be able to access therapy in their native language?

Our clients have expressed that being able to receive therapy in their own languages is a luxury. We understand how important the language barrier can be. At Sinews we speak our patients’ language, and our therapists have experienced what it’s like to live in a foreign country, to be part of a mixed marriage or to be third culture kids; these all come very handy in empathising with the patient and their problems. Our mother language is directly connected with our emotional brain.

Finding the right kind of therapy can feel overwhelming. How do you guide individuals and families in choosing the approach that will work best for them?

After receiving contact from the patient, we locate one of our professionals that adapts to their schedule, language and their consultation motive (if they mention it). Then, we start with an initial consultation where we provide an assessment for the case: gathering information about the problem and its circumstances. Once an assessment has been made, we will explain to our client what their problem consists of, and present to them a therapeutic plan to fit their needs.

We also have a search engine in the Our Team section of our website where clients can look for a therapist in a certain language, for a concrete difficulty or a specific type of therapeutic approach.

What types of challenges do your clients typically come to you with? Are there any common themes within the international community in Madrid?

Most of our clients are highly functional, they struggle with stress disorders, insomnia, anxiety or mood difficulties. Parents usually come to us concerned about their kid’s social integration after an international move or the children’s distress as a result of a divorce. Lately as red flags for ADD, dyslexia or autistic spectrum are better known by teachers, many are referred to us from schools.

For parents who might be concerned about their child’s emotional well-being, what signs should they look out for that suggest professional support could be beneficial?

It is normal for children to feel sad, nervous, or afraid sometimes, and all children misbehave or talk back to their parents occasionally. This is developmentally appropriate and usually is not anything to worry about. However, children who have mental health problems often experience a lot of emotional distress, family conflict, school failure, body image distortion, problems with friends and may even have thoughts of suicide.

If a child’s mood and/or behaviours have a sustained (more than two weeks), functional impact in one or more areas of their life (school, family and social) it is a good idea to consult a child psychologist, or psychiatrist who works with children and adolescents.

How do therapy sessions at Sinews work? Are they in-person, online, or a mix of both?

We offer both in-person and online sessions for all our services except psycho-educational evaluations that need to be done in person, since the testing equipment is all based at the clinic.

We don’t recommend online therapy for children under 12 unless there is no professional in your area speaking the child’s language. Also, there are specific problems where online therapy is not ideal.

Many parents choose online for parenting sessions though as it is much easier and more viable for them saving time and effort. Many of our adolescents use a mixed model with some online sessions here and there when they have exams, or training or are mildly sick and of course during holidays in their family’s country of origin.

For someone new to therapy, what should they expect in their first session at Sinews?

The first session is an assessment to get to know the patient and for the patient to get to know the therapist as well, that they feel comfortable and in a safe place where it is possible to gather information about the problem and its circumstances. Overall, the patient should expect to feel heard, respected and validated in the emotions he or she encounters. 

Sinews integrates different therapeutic approaches, from Cognitive-Behavioural Therapy (CBT) to coaching and couples therapy. How do you decide which method is best suited to a client?

Depending on the patient’s problem, we’ll try to select a professional that has background experience directly in this area. This way, the patient’s needs will be covered, and their therapeutic process will be more effective.

Also, some clients are very clear about what they want, as a result of previous experiences or thanks to a recent increase in mental health awareness and knowledge about different therapeutic approaches and their uses.

Are there any alternative or lesser-known therapies that Sinews offers that people might not be familiar with?

Yes! EDMR therapy is in very high demand and experiencing lots of popularity. Some people don’t know about this therapeutic approach yet. EMDR, known as Eye Movement Desensitisation and Reprocessing, is designed to assist individuals in overcoming emotional traumas and uses a pre-hypnotic state to access and reprocess the trauma memories. We highly recommend it for people with PTSD as it helps patients out of the dissociation, the re-experiencing, and the avoidance.

Another very useful type of therapy is ACT (Acceptance and Commitment therapy), a third-generation modality of cognitive behavioural therapy that pays much more attention to emotions. It focuses on the way we struggle with the thoughts and feelings that we fail to accept and how commitment to a balanced life aligned with our values can be the key to contentment.

Also, we have a speech therapist in our team trained in PACT (Paediatric Autism Communication Therapy) a language and communication therapy for children with autism or social communication needs using video feedback to help parents understand their child’s communication. Through learning to respond to their child’s communication, parents build a deeper and more significant connection with their child. This technique helps children on the Autism spectrum learn to initiate communication.

Do you have any success stories (without breaking confidentiality, of course) that highlight the impact of finding the right kind of therapy?

We do! We are so grateful when our clients send us thankful emails or write a lovely review in Google. Here are some examples: 

“I arrived as an international student seeking an evaluation. I contacted Sinews about my interest and was assigned an appointment and a professional almost immediately. The speed of appointments and the quality of the staff are unmatched. I worked with Chaimaa during my three months in Madrid, and she made me feel so comfortable and happy with my evaluation that I decided to continue with her for therapy. I highly recommend Sinews and working with Chaimaa!” – Gabriela Forero, Janaury 2025.

“I have used Sinews for many years including for diagnostic assessments, individual therapy, psychiatry and individual tutoring support. I love the friendly and knowledgeable staff and have recommended Sinews to many of my closest friends and family members who have all seen very positive and effective results. Sinews has a reputation for being the best practice in Madrid and my experience certainly supports that.” – Julie Coles, November 2024.

“I’m originally from New York and lived in Madrid for six years. Just before the pandemic, I repatriated and moved to Florida. I have to say that among the doctors and psychologists I’ve had in New York, Florida, and Madrid, the care I received at SINEWS is simply unparalleled. One of the things I miss most about Madrid.” – Scott Corr, 2022.

What would you say to someone hesitant about starting therapy, especially if they’re unsure which approach or therapist is right for them?

When we’re troubled by something or feeling bad, it isn’t always easy to look for help, we may not even know what is happening to us or why. 

Information is key. We often fear the unknown and this increases our hesitation to try therapy or take the first step in our therapeutic process. That’s why at SINEWS we will provide you with as much information as you’d like about diagnostics, the factors that cause and sustain your problem, the therapeutic plan (approximate duration, cost etc) and treatment alternatives.

For those interested in starting therapy with Sinews, what does the process look like? How can they take the first step?

It is very simple, they can contact us via email, phone or WhatsApp. Our wonderful reception team will assist them in scheduling an appointment, responding to inquiries and giving out general information that the patient may need. Our reception team is bilingual as well, so communication will not be an issue!

Finally, is there any key advice you’d share with expats trying to prioritise their mental well-being, while adapting to life in a new country?

When building a new routine, don’t forget to include from the very beginning (no matter how super busy you are) what you know are the sinews of your wellbeing:

• Exercise. Whatever you enjoy doing – this could be something as simple as fast walking.
• Sleep. Try to adapt as quickly as possible to the new country schedules.
• Hobbies. Find a place for dancing if that’s your passion, make time for reading, or start knitting again, do ceramics – the eye-hand-brain connection is so potent that it will keep over-worrying under control.
• Warms social interactions. Try to find a balance between meeting new people and connecting with your beloved ones back home. 
• Connection with nature can also be very restorative and we need no more than a quiet park.

And most importantly, be patient with yourself – adaptation is a process full of ups and downs!

Find out more about Sinews on their website.

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